A Prospective Study of Chronic Obstructive Pulmonary Disease and the Risk for Mild Cognitive Impairment

Singh, Balwinder; Mielke, Michelle M.; Parsaik, Ajay K.; Ruth, H.; Roberts, Rosebud O.; Scanlon, Paul D.; Geda, Yonas E.; Christianson, Teresa J.H.; Pankratz, V. Shane; Petersen, Ronald C.

doi:10.1001/jamaneurol.2014.94

Cited by 107 publications

(120 citation statements)

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“…It has been reported that no statistically significant association was found between the two groups in terms of chronic bronchitis after adjusting for independent variable factors (sex, age, education level and major occupation before 60 years of age). The result was different from that obtained by Singh [6], suggesting that chronic bronchitis may have little or no effect on cognitive function in Chinese elderly people over 90 years of age.…”

Section: Discussioncontrasting

confidence: 95%

“…[ 14] A study included 1425 cognitively normal individuals aged 70 to 89 years , with 5.1 years follow-up, Then author concluted that COPD as a risk factor for MCI and may provide a substrate for early intervention to prevent or delay the onset and progression of MCI, particularly NA-MCI. [6] Another population-based study thought that with more than 25 years of follow-up, midlife COPD and asthma were associated with an almost two-fold risk of MCI and dementia later in life. Pulmonary diseases diagnosed later in life seemed to have an inverse relationship with cognitive impairment probably reflecting survival bias.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5] and chronic bronchitis is considered to be one of the most influential factors relating to cognitive function. [ 6] The primary aim of the present study was to investigate the association between chronic bronchitis and cognitive impairment in elderly (over 90 years of age) Chinese subjects.…”

Section: Introductionmentioning

confidence: 99%

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Association between Chronic Bronchitis and Cognitive Impairment in Elderly Chinese Subjects Over 90 Years of Age

Gao¹

2014

AJHR

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Abstract:Objective: chronic bronchitis may have a key influence on cognitive function, however, the relationship between chronic bronchitis and cognitive impairment in the elderly Chinese population has not been explored. The present study investigated the association between cognitive impairment and chronic bronchitis in elderly Chinese subjects over 90 years of age. Methods: This study comprised data from subjects included in the 2005 Project of Longevity and Ageing in Dujiangyan, China. Subjects were divided into two groups: cognitive impairment group and normal group. Chronic bronchitis data were collected and cognitive function was assessed in all subjects using the Mini-Mental State Examination. Data were presented as mean±standard deviation (SD) or number and percentage. All data were computerized for statistical analysis using the Statistical Package for Social Sciences (SPSS) software package, version 11.5 software program. Results: Data from 763 subjects (249 men, 514 women) were included. There was no statistically significant difference in history of chronic bronchitis between the two groups. Education level in the cognitive impairment group was significantly lower than in the normal group. Conclusions: chronic bronchitis were not related to cognitive impairment in elderly Chinese people over 90 years of age.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Association between Chronic Bronchitis and Cognitive Impairment in Elderly Chinese Subjects Over 90 Years of Age

Gao¹

2014

AJHR

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“…2 Several of the common chronic conditions that contribute to multimorbidity are established risk factors for mild cognitive impairment (MCI) or dementia (e.g., vascular diseases, cerebrovascular disease, depression, or chronic obstructive pulmonary disease). [3][4][5][6][7][8] We hypothesized, therefore, that multimorbidity may also be associated with abnormal brain imaging findings that are characteristically present in persons with Alzheimer disease (AD) dementia, but this association has not been studied. Thus, the objective of this study was to determine the cross-sectional associations between multimorbidity and in vivo biomarkers of brain pathology (atrophy, increased amyloid accumulation, and reduced metabolism) assessed by MRI, METHODS Study population.…”

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confidence: 99%

Multimorbidity and neuroimaging biomarkers among cognitively normal persons

et al. 2016

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Objective: To assess the cross-sectional association between multimorbidity and imaging biomarkers of brain pathology in the population-based Mayo Clinic Study of Aging (MCSA). Methods:The study consisted of 1,449 MCSA participants who were cognitively normal at the time of MRI. A subset of the participants also had 11 C-Pittsburgh compound B (n 5 689) and 18 fluorodeoxyglucose (n 5 688) PET scans available. Information on multimorbidity (defined as $2 chronic conditions) in the 5 years prior to the first imaging study was captured from the medical record using ICD-9 codes for chronic conditions and the Rochester Epidemiology Project medical records linkage system. The cross-sectional association of multimorbidity and imaging biomarkers was examined using logistic and linear regression models.Results: Among 1,449 cognitively normal participants (mean age 79 years; 50.9% men), 85.4% had multimorbidity ($2 chronic conditions). Multimorbidity and severe multimorbidity ($4 chronic conditions) were associated with abnormal Alzheimer disease (AD) signature meta-region of interest (meta-ROI) 18 Conclusions: Multimorbidity was associated with brain pathology through mechanisms independent of amyloid deposition and such neuronal injury and pathology was present before any symptomatic evidence of cognitive impairment. Longitudinal follow-up will provide insights into potential causal associations of multimorbidity with changes in brain pathology. Multimorbidity has a prevalence of 20%-30% in the general population, 1 and increases with age from 55% to 98% among persons older than 60 years.1 Multimorbidity is becoming the norm among adults in primary care settings, 2 mandating the need to investigate not only the causes, but also the association with future health outcomes. Multimorbidity is associated with an increased risk for hospitalizations and increased length of stay, worsening quality of life and physical functioning, polypharmacy, mild cognitive impairment, 3 and depression, resulting in significant economic costs for the health care system.2 Several of the common chronic conditions that contribute to multimorbidity are established risk factors for mild cognitive impairment (MCI) or dementia (e.g., vascular diseases, cerebrovascular disease, depression, or chronic obstructive pulmonary disease).3-8 We hypothesized, therefore, that multimorbidity may also be associated with abnormal brain imaging findings that are characteristically present in persons with Alzheimer disease (AD) dementia, but this association has not been studied. Thus, the objective of this study was to determine the cross-sectional associations between multimorbidity From the Departments of Health Sciences Research

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“…We now recognize that there is more to Alzheimer's disease than beta amyloid [18] and that declines in cognition may be triggered by a variety of vascular [19], traumatic [20], and metabolic factors. When a patient shows decline from an established personal cognition baseline, it would trigger an investigation of potential contributing causes such as hypoxia or obstructive sleep apnea [21,22] thyroid abnormality [23], hyper homocysteinemia [24], or elevated hemoglobin A1C [25], or a medication review for contributing agents such as benzodiazepines [26,27] or anti-cholinergics [28]. Any and all of these conditions can impair cognition and hasten cognitive decline.…”

Section: As An Indicator Of Other Possible Medical Problemsmentioning

confidence: 99%

Dementia Screening: Saying No to the USPSTF and Yes to Brief Cognitive Evaluation

Clionsky¹

2014

J Alzheimers Dis Parkinsonism

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Recently, the U.S. Preventive Services Task Force [1] released a widely-publicized review advocating against screening for dementia in older adults. After their review of the literature, they concluded that dementia screening did no harm, but likely did little good. Their position was not based on evidence demonstrating negative outcomes for screening, as they were unable to find any particularly relevant studies that addressed the outcomes question directly. Nor was it based on significant medical risks arising from dementia treatments. They cited the common side effects of cholinesterase inhibitors and memantine, which have been known for decades and are surprisingly minimal for an old and often infirm patient population. Instead, they argued that presently available dementia treatments were not very effective. In other words, if we do not yet have good treatments, why identify the disease state?In our opinion, the USPSTF's reasoning is flawed and their conclusion is potentially harmful to patients suffering from or developing dementia. We believe that the USPSTF position leaves the public and many physicians confused about what to do and the patients with cognitive loss disenfranchised. We Concur, and Here is WhyFirst, and in rebuttal to the USPSTF assertion, the treatment picture for dementia is not as dismal as their position suggests. A contemporaneous review of the same literature [7] makes a convincing case that cholinesterase inhibitors and memantine slow cognitive and functional decline and delay nursing home placement. It also finds that combined treatment is superior to monotherapy. A previous large scale investigation [8] found that patients on continuous anti-dementia treatment lived three years longer, on average, than those who had no treatment or interrupted medication. Add to this a finding from residential care settings [9] documenting better function in patients taking anti-dementia medication, including a reduced need for antipsychotic medications that carry an FDA "black-box" warning. There are a number of single studies with similar findings which became the basis for FDA approval of dementia drugs. We can add to the clinical findings the economic benefit that treatment of dementia with donepezil reduces costs of other medical services [10].But, as noted before, treatment outcome should not be the primary or the governing reason for screening of cognition. In fact, we will argue that screening should be reframed or re-conceptualized in broader terms. We propose to replace the limited concept of screening with a more robust and useful concept called "Brief Cognitive Evaluation" or BCE. Brief Cognitive EvaluationBrief Cognitive Evaluation would employ an economical, easily administered, validated, performance-based tool to produce a metric that is reliable, sensitive to change over time, and useful in broader contexts. In our view, BCE would occur during primary care visits for older patients to measure each patient's global cognitive level as it exists today, just as we measure other impor...

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A Prospective Study of Chronic Obstructive Pulmonary Disease and the Risk for Mild Cognitive Impairment

Cited by 107 publications

References 45 publications

Association between Chronic Bronchitis and Cognitive Impairment in Elderly Chinese Subjects Over 90 Years of Age

Association between Chronic Bronchitis and Cognitive Impairment in Elderly Chinese Subjects Over 90 Years of Age

Multimorbidity and neuroimaging biomarkers among cognitively normal persons

Dementia Screening: Saying No to the USPSTF and Yes to Brief Cognitive Evaluation

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